JP4932266B2 - Endoscope system - Google Patents

Description

  The present invention relates to an endoscope system that can be used for transendoscopic treatment and can collect tissue collected from a living body.

  Conventionally, as a method of recovering collected biological tissue, there is a method of sucking a tissue excised with a treatment tool using a channel of an endoscope. For example, there is a structure in which a chamber that can be sealed with a cap is formed in a forceps port of a forceps channel of an endoscope, and a mesh trap is disposed in this chamber to constitute a tissue collection trap (see, for example, Patent Document 1). A pipe that also serves as a forceps channel and constitutes a suction conduit is inserted inside the net cage, and a pipe connected to a suction device is arranged outside the net cage. When the suction device is operated, the tissue excised in the body is guided through the pipe to the net. The net has a shape that allows fluid to pass but not tissue, and only the tissue is captured by the net.

In addition, there is a type in which a suction tube is pulled out of the endoscope from the proximal end portion of the forceps channel of the endoscope, and a valve and a recovery trap are provided in the middle of the suction tube and then connected to a suction device (for example, Patent Document 2). When a tissue such as a polyp is excised with excision forceps passed through the forceps channel, the excision forceps are extracted from the forceps channel and the forceps port is closed with a forceps plug. Next, when the valve is opened, the suction force by the suction device acts on the forceps channel through the suction tube, and the tissue is sucked. Tissue enters the suction tube from the forceps channel and is collected in a collection trap through the outside of the endoscope.
Japanese Utility Model Publication No. 62-74804 Japanese Patent Laid-Open No. 11-267089

However, in the configuration as disclosed in Patent Document 1, a recovery trap is formed in the forceps channel through which the treatment tool is passed. For example, if the treatment tool is inserted without attaching the mesh, It was difficult to insert later. In this case, the tissue cannot be recovered immediately after the tissue is excised, and the excised tissue may be lost while the reticulum is attached. In addition, since the reed is inserted into the forceps channel, the operability when the treatment tool is inserted into or removed from the forceps channel is poor.
On the other hand, Patent Document 2 discloses a configuration in which the recovery trap is disposed at a position away from the forceps channel. However, in this configuration, three conduits of an endoscope insertion portion extending from the endoscope operation portion held by the operator to the body, a universal cord extending to the control unit, and a suction tube for tissue recovery Because it would extend separately, the operability was poor for the surgeon. In addition, since the endoscope is disposed at a position away from the collection trap, it is difficult for the operator to remove the collected tissue from the collection trap while operating the endoscope, and to attach / detach the collection filter. Met.
The present invention has been made in view of such circumstances, and a main object thereof is to reduce an operation burden on an operator in an endoscope system including a tissue recovery apparatus that recovers a tissue.

The endoscope system of the present invention includes an endoscope having an endoscope operation unit operated by an operator, and an endoscope insertion unit that extends from the endoscope operation unit and is inserted into the body, and the endoscope A distal end opening formed in the distal end portion of the endoscope insertion portion, and a proximal end portion connected to the aspirator through the endoscope, and the conduit is connected to the endoscope operation portion A working channel in which an intermediate opening is formed and a treatment tool can be inserted from the intermediate opening toward the distal end opening, and one end of the endoscope operation portion communicates with the working channel and the other end serves as the base end portion. A suction conduit connected to the suction device, and the endoscope operation section is downstream of the working channel in the suction direction by the suction device from the proximal end portion of the conduit. The tissue sucked from the distal end opening toward the aspirator side through the conduit Capable of capturing the tissue recovery device is provided, wherein the bifurcation working channel and said suction conduit is branch connected to the endoscope operating section, the tissue recovery device, the suction pipe and the branch portion An endoscope system characterized in that the endoscope system is interposed between a path and a road .
In this endoscope system, a tissue collection device is provided in an endoscope operation unit, and a pipe line connecting the endoscope and the tissue collection device is not routed outside the endoscope. The tissue passes through the branch portion from the distal end portion of the endoscope insertion portion and is collected by the tissue collection device. In addition, the tissue collection device is arranged in a pipeline after branching from the working channel. When the treatment tool is passed through the endoscope, the treatment tool passes through the branch portion and protrudes from the distal end portion of the suction conduit, so that the treatment tool does not interfere with the tissue collection device.

In this case, a branch portion is provided in the middle of the working channel, and the tissue is recovered by the tissue recovery device through a pipe branching from the branch portion. The fluid sucked together with the tissue is discharged from the tissue collection device through the suction line in the endoscope. For this reason, a pipe line used only for exhaust is not routed outside the endoscope. In addition, since the tissue collection device is arranged in the pipeline after branching from the working channel, the treatment tool does not interfere with the tissue collection device.

In the endoscope system of the present invention, a part of the working channel including the branch portion and a distal end portion of the suction conduit connected to the tissue recovery apparatus are connected to the endoscope operation portion. It is preferable to have an attachment formed so as to be detachable integrally .
In this endoscope system, the tissue collection device is connected to the endoscope via an attachment. The suction operation can be performed without drawing the conduit for the tissue collection device out of the endoscope.

Moreover, it is preferable that the said tissue collection | recovery apparatus is detachable with respect to the said attachment.
This endoscope system can be handled separately by removing the tissue collection device from the attachment. This is convenient when collecting tissue multiple times in succession or when washing after use.

Moreover, it is preferable that the said attachment is manufactured from the elastic member .
In this endoscope system, the attachment can be easily attached to the endoscope. Further, since the durability of the attachment is relatively lower than that of the endoscope, the entire endoscope system can be made inexpensive.

Further, the attachment has a bypass line that bypasses the tissue recovery apparatus and connects the connection line and the suction line, and the bypass line is blocked when the tissue recovery apparatus is attached. When the tissue recovery device is removed, it is preferably opened.
In this endoscope system, when the tissue recovery apparatus is not used, the working channel side and the suction pipe line can be communicated with each other through the bypass pipe line.

The tissue recovery apparatus preferably includes a tissue recovery case and a tissue recovery filter that is detachable from the tissue recovery case .
This endoscope system can recover tissue by removing only the tissue recovery filter with the tissue recovery case attached to the endoscope side. When the tissue is continuously collected a plurality of times, the tissue collection filter is repeatedly attached and detached each time the tissue is aspirated.

In addition, the attachment includes a main body part that is attached to and detached from the endoscope, and a valve body that is rotatably inserted into the main body part, and the valve body includes a distal end part of the suction conduit, A first rotational position for communicating with the base end of the working channel via a bypass line; the bypass line is blocked; a tip end of the suction line; and a base end of the work channel; It is preferable that the second rotation position for opening each of them separately can be selected so as to be freely rotatable.
In this endoscope system, by rotating the valve body, a conduit system that performs suction through the tissue collection device and a conduit system that directly connects the suction conduit to the working channel through the bypass conduit are selectively used. You can switch to

In addition , the tissue recovery filter has two tissue capturing surfaces that are integrated with each other, and the tissue recovery case is substantially perpendicular to the fluid flow path for sucking tissue. it is preferably configured so that the tissue recovery filter is mounted so as to be disposed.
This endoscope system can carry out tissue recovery simply by attaching a tissue recovery filter to the tissue recovery case without being bound by the direction of the tissue recovery filter.

In the endoscope system of the present invention, a distal-side connection port provided at a proximal end of the connection conduit of the attachment and connectable to the tissue recovery device, and a distal end portion of the suction conduit in the attachment It further includes a connecting member that is mounted on a proximal end side connection port that is provided in a pipe line that can be connected to the tissue recovery apparatus and that fluidly connects the working channel and the suction pipe line. .
In this endoscope system, when the connecting member is mounted, the working channel and the suction pipe line are connected through the pipe line of the connecting member.

In addition, the endoscope system of the present invention includes a first plug body that can be attached to a distal end side connection port of the connection pipe line that is opened to the outside when the tissue collection device is detached from the attachment; It is preferable to include a second plug body that can be attached to the distal end side connection port of the connection pipe line that is opened to the outside when the tissue collection device is detached from the attachment.
In this endoscope system, when the tissue collection device is removed, two plugs are attached to seal the opening of the duct. When the plug body has a shape that does not block the bypass conduit, the working channel and the suction conduit communicate with each other through the bypass conduit in the attachment.

In addition, the attachment has a first surface that faces the endoscope operation unit when the attachment is attached to the endoscope operation unit, and the tissue recovery is performed on a second surface opposite to the first surface. The apparatus is configured to be arranged.
In this endoscope system, since the tissue collection device is arranged on the opposite side of the endoscope as viewed from the attachment, it is easy for an operator to handle the tissue collection device.

The tissue collection device is detachable from the suction conduit.
In this endoscope system, the tissue collection device can be removed from the suction line, that is, the endoscope, and handled separately. This is convenient when collecting tissue multiple times or washing after use.

  According to the present invention, there is no need to separately route a conduit for aspirating and collecting tissue to the outside of the endoscope, so that the burden on the operator when operating the endoscope system can be reduced. Becomes easier. Since the branch line is branched at the branch portion, the treatment tool is inserted from one of the branched lines, and the tissue is guided to the tissue recovery apparatus through the other pipe line. It is possible to perform the surgeon's procedure efficiently without getting in the way.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
(First embodiment)
FIG. 1 shows a schematic configuration of an endoscope system according to the embodiment. The endoscope system 1 includes an endoscope 2, a tissue collection device 3 attached to the endoscope 2, a control unit 4 of the endoscope 2, and an aspirator 5.

  The endoscope 2 includes an endoscope operation unit 10 that is operated by an operator, and a long endoscope insertion unit 11 that extends from the distal end of the endoscope operation unit 10 and has flexibility. The endoscope operation unit 10 is provided with an angle knob, various buttons, and switches, and is connected to the control unit 4 via the universal cable 12. A suction line 20 is formed inside the endoscope 2. The suction conduit 20 has a distal end opening 21 at the distal end of the endoscope insertion portion 11 and extends to the endoscope operation portion 10, and a first conduit portion 20 </ b> A and a first conduit portion 20 </ b> A. A branch portion 22 provided at the proximal end and a second conduit portion 20B drawn from the branch portion 22 through the endoscope operation portion 10 into the universal cable 12 are provided. The proximal end portion 24 is connected to the aspirator 5. Note that the endoscope 2 may be provided with other conduits (not shown).

  In the endoscope operation section 10, a collection mounting section 25 is recessed in the second pipe section 20 </ b> B on the proximal end side with respect to the branch section 22 of the suction pipe 20. The opening of the collection mounting portion 25 protrudes radially outward from the outer periphery of the endoscope operation unit 10, and a flange 25 </ b> A is formed in an annular shape on the outer periphery of the opening. As shown in FIG. 2, the tissue collection device 3 is detachably attached to the collection mounting unit 25 so as to seal the opening. The tissue collection device 3 includes a lid 31 that seals the opening of the collection mounting unit 25. The lid 31 is formed with a claw 31A that is engaged with the collar 25A of the collection mounting portion 25 and a knob 31B that is held by the operator. A filter portion 32 extends on the inner surface side of the lid portion 31. The filter portion 32 has a mesh structure and extends so as to cross the suction conduit 20. The mesh is formed so that a large number of holes are substantially parallel to the suction conduit 20, and a surface facing the suction conduit 20 and a back surface with respect to the surface serve as a tissue capturing surface. In addition, the clearance gap between the collection | recovery mounting part 25 and the filter part 32 is a magnitude | size which is a grade which a structure | tissue cannot pass.

  A distal end side opening portion 26 of the working channel 23 is connected to the branch portion 22 of the suction conduit 20. The proximal end side connection port 27 of the work channel 23 is formed in the side portion 28 of the endoscope operation unit 10. A plug 35 is attached to the proximal end side connection port 27. A hole 36 that can communicate with the working channel 23 is formed in the plug 35, and the hole 36 forms a treatment instrument insertion port 37. The plug 35 is manufactured from, for example, an elastic member, and the hole 36 is sealed in a state where no treatment tool is inserted. In the working channel 23, when the treatment instrument is inserted, the treatment instrument is inserted into the first duct portion 20A of the suction conduit 20, and the treatment instrument protrudes from the distal end opening 21 of the suction conduit 20. In this manner, the suction pipe 20 is connected to the branch portion 22.

Next, the operation of this embodiment will be described.
First, the endoscope insertion portion 11 is inserted from the patient's mouth and guided to the site where the tissue is collected. When excising the tissue, a treatment instrument (for example, excision forceps, snare, etc.) is inserted from the treatment instrument insertion port 37. The treatment instrument is inserted from the treatment instrument insertion port 37 of the plug 35 into the proximal end side connection port 27 of the working channel 23, and follows the shape of the branch portion 22 from the distal end side opening portion 26 to the distal end side of the suction conduit 20. Led. Furthermore, it proceeds into the endoscope insertion portion 11 along the suction conduit 20 and protrudes from the distal end opening 21. When the treatment tool is an excision forceps, a pair of forceps pieces provided at the distal end are opened and closed to excise the tissue to be collected. When the resection is completed, the resection forceps are extracted from the endoscope 2. The treatment instrument is extracted from the working channel 23 from the suction pipe 20 through the branch portion 22. The treatment instrument insertion port 37 of the plug 35 is closed by the self-restoring force.

  When the tissue is collected, the aspirator 5 is operated. Since the tissue collection device 3 and the suction line 20 are kept airtight, and the work channel 23 side is kept airtight by the stopper 35, the tip opening 21 of the suction line 20 has a structure shown in FIG. A suction force acts as indicated by an arrow, and the excised tissue is drawn into the suction conduit 20. In the suction line 20, the tissue is guided to the collection mounting portion 25 through the branch portion 22 as indicated by an arrow. The tissue collection device 3 is mounted on the collection mounting unit 25, and the mesh structure of the filter unit 32 allows fluid to pass but not tissue, so that the tissue is filtered as shown by phantom lines in FIG. It is caught in the part 32. When the aspirator 5 is stopped and the tissue recovery device 3 is removed from the recovery mounting portion 25, the tissue captured by the filter portion 32 is recovered.

  According to this embodiment, since the tissue collection device 3 is directly mounted on the endoscope 2 side, the number of pipelines extending from the endoscope operation unit 10 to the outside can be reduced. Furthermore, since the tissue collection device 3 is fixed to the endoscope 2, the tissue collection device 3 can be easily handled. Therefore, the burden on the operator can be reduced and the procedure can be performed promptly. Furthermore, since the tissue collection device 3 is provided on a pipeline branched from the working channel 23 which is a pipeline through which the treatment tool is inserted and removed (the proximal end side of the branch portion 22 of the suction pipeline 20), Easy to insert and remove tools.

(Second Embodiment)
A second embodiment will be described with reference to FIGS. In addition, the same code | symbol is attached | subjected to the same component as 1st Embodiment. In addition, overlapping explanation is omitted.
As shown in FIGS. 3 and 4, the endoscope system 51 includes an endoscope 52, a control unit 4, an aspirator 5, an attachment 53 detachably attached to the endoscope 52, and an attachment 53. A tissue recovery device 54 fixed to the endoscope 52.

  The endoscope 52 includes an endoscope operation unit 60 and an endoscope insertion unit 61 that are different from the first embodiment only in the configuration of the pipeline. In the endoscope 52, a working channel 65 and a suction conduit 66 are formed. The working channel 65 has a distal end opening portion 65 </ b> A at the distal end portion of the endoscope insertion portion 61 and extends to the side portion 67 of the endoscope operation portion 60. The base end side connection port of the working channel 65 protrudes from the side portion 67 to form a first connection portion 68. The side portion 67 also has an opening 66 </ b> A of the suction pipe line 66 opened. This opening is formed in the second connection portion 69 protruding from the side portion 67. The suction conduit 66 passes through the universal cable 12 from the endoscope operation unit 60, and the base end portion 66 </ b> B is connected to the suction device 5. The first connection portion 68 and the second connection portion 69 protrude from the side portion 67 substantially in parallel.

  An attachment 53 is attached to the first and second connection portions 68 and 69. The attachment 53 is manufactured from a material having lower hardness and strength than the endoscope 52 side, such as a resin or an elastic material. As shown in FIGS. 4 to 6, the attachment 53 is formed such that the first connecting pipe 70 forming a part of the work channel 65 penetrates from the upper surface 53 </ b> A of the attachment 53 to the surface 53 </ b> B. The first connection pipeline 70 has a shape in which the first connection portion 68 can be fitted on the lower surface 53B side. A treatment instrument insertion port 71 is formed on the upper surface 53 </ b> A side of the first connection conduit 70. Further, a branch portion 72 is formed in the pipe line of the first connection pipe line 70, and a first connection pipe line 73 extends therefrom. The first connection pipe 73 opens on the side surface 53 </ b> C of the attachment 53, and this opening becomes the tip side connection port 74. A bypass conduit 75 is connected in the conduit of the first connection conduit 73. The bypass conduit 75 passes through the second connection conduit 76 and opens to the side surface 53 </ b> D of the attachment 53. When the lower surface 53B of the attachment 53 is disposed downward, the bypass conduit 75 has a gradient such that the first connection conduit 73 side is relatively higher than the second connection conduit 76 side. The diameter of the bypass conduit 75 is smaller than the diameter of the first and second connection conduits 73 and 76.

  The second connection conduit 76 extends substantially parallel to the first connection conduit 73, and one end portion forms a proximal end connection port 77 on the side surface 53 </ b> C of the attachment 53. The other end is connected to the second connecting conduit 78 in the attachment 53. The second connection pipeline 78 has an opening only on the lower surface 53 </ b> B of the attachment 53. The opening has a shape in which the second connecting portion 69 on the endoscope 52 side can be fitted.

  A tissue recovery device 54 is detachably attached to the distal end side connection port 74 and the proximal end side connection port 77 of the attachment 53. As shown in FIGS. 4 and 7 to 9, the tissue recovery device 54 includes a tissue recovery case 80 and a tissue recovery filter 81 that is detachable from the tissue recovery case 80. The tissue recovery case 80 has a bottomed cylindrical case body 82 manufactured from a material whose inside can be visually confirmed. A distal end side conduit 84 and a proximal end side conduit 85 extend from the side of the case body 82 in an oblique manner and parallel to each other in order from the opening 83 side. The distal end side pipe 84 is provided with an annular protrusion 84A and an annular protrusion 84B having a larger diameter than the annular protrusion 84A in order on the outer periphery thereof. The proximal end side pipe 85 is provided with an annular protrusion 85A and an annular protrusion 85B having a larger diameter than the annular protrusion 85A in order on the outer periphery thereof. These conduits 84 and 85 communicate with the inside of the case main body 82.

  The case body 82 has a circular opening 83, and a pair of locking projections 83 </ b> A are provided on the outer periphery of the opening 83. The locking projection 83 </ b> A is disposed on one diameter of the opening 83. The inside of the opening 83 of the case main body 82 has a tapered surface 83B that decreases in diameter toward the bottom 82B of the case main body 82. A lid 86 is inserted on the bottom 82B side of the opening 83 of the case body 82. The lid 86 is slidable in the longitudinal direction of the case body 82 while being hermetically sealed with the inner wall of the case body 82 by a sealing material 87. Here, one groove 88 for communication is formed along the longitudinal direction on the inner peripheral side of the case main body 82, and when there is a lid 86 in the middle of the groove 88, from the upper surface of the lid 86. The space 89 </ b> A to the opening 83 of the case main body 82 and the space 89 </ b> B from the bottom surface of the lid 86 to the bottom 82 </ b> B of the case main body 82 can be communicated with each other. The groove 88 extends from the bottom portion 82 </ b> B to the trouble of the connection position of the distal end side pipe line 84. A coil spring 90 as an urging means is inserted between the lid 86 and the bottom portion 82 B of the case main body 82, and the lid 86 is urged toward the opening 83. As shown in FIG. 9, in the no-load state, the lid 86 abuts against the stepped portion 91 formed by the tapered surface 83B, so that no more goes out. At this position, the inside of the case main body 82 communicates with the distal end side conduit 84 and the proximal end side conduit 85, and the opening 83 is sealed by the lid 86.

  As shown in FIGS. 7, 8, and 10, the tissue collection filter 81 has a lid portion 95 that can be inserted into the opening 83 of the case body 82, and the filter portion 96 extends from the lid portion 95. Yes. The lid portion 95 is provided with a pair of fixing portions 97. These fixing portions 97 can be clickably locked to the locking protrusions 83 </ b> A of the case main body 82. Further, an O-ring 98 that is a sealing material is attached to the lid portion 95, and is crushed by the tapered surface 83B to seal the opening 83 of the case main body 82. The filter portion 96 has a mesh shape through which fluid can pass but tissue is caught. The filter unit 96 has two tissue capturing surfaces 96A integrally on the front and back sides. The tissue capturing surface 96 </ b> A is disposed substantially at right angles to a line segment connecting the pair of fixing portions 97. Therefore, when the fixing portion 97 is locked to the locking protrusion 83A on the case main body 82 side, one of the tissue capturing surfaces 96A is always arranged facing the distal end side conduit 84. The filter 81 can be attached regardless of the orientation. The gap between the filter unit 96 and the case main body 82 is large enough to prevent tissue from passing therethrough.

  A plate 100 is provided at the tip of the filter unit 96. As shown in FIG. 11, the plate 100 is provided with a notch 101 so that the liquid in the case main body 82 is not scraped off when the tissue recovery filter 81 is removed. As shown in FIG. 7, when the tissue recovery filter 81 is attached to the tissue recovery case 80, the plate 100 at the tip of the filter portion 96 pushes the lid 86 back toward the bottom portion 82B. The filter unit 96 pushes back the lid 86 against the coil spring 90 so that the lid 86 comes to a position corresponding to between the distal end side conduit 84 and the proximal end side conduit 85.

  As shown in FIG. 12, when the tissue collection device 54 is attached to the attachment 53, the distal end side conduit 84 is inserted into the first connection conduit 73. The distal end side pipe line 84 enters the branch portion 72 beyond the connecting position of the bypass pipe line 75. The annular protrusion 84A is locked to the annular groove 73A of the first connection pipe 73, and the annular protrusion 84B abuts against the side surface 53C. As a result, the first connection pipe line 70 and the space 89A of the tissue collection device 54 communicate with each other. Here, the filter portion 96 of the tissue recovery filter 81 is inserted. Similarly, the proximal end side pipe line 85 is inserted into the second connection pipe line 76, and the distal end portion exceeds the bypass pipe line 75. The annular protrusion 85A is locked to the annular groove 76A, and the annular protrusion 85B abuts against the side surface 53C. As a result, the second connection pipe line 78 and the space 89 </ b> B of the tissue collection device 54 communicate with each other.

  Since the lid 86 is in the middle of the groove 88 of the case main body 82, the first connection pipe line 70 and the second connection pipe line 78 communicate with each other through the groove 88 and the spaces 89A and 89B. In addition, since the distal end side conduit 84 and the proximal end side conduit 85 are inserted beyond the position where the bypass conduit 75 is formed, the bypass conduit 75 is blocked. Since the length of the distal end side conduit 84 is longer than the length of the proximal end side conduit 85, the tissue collection device 54 is inclined so that the opening 83 side is farther from the attachment 53 than the bottom 82B side. Fixed.

  When the tissue collection device 54 is removed from the attachment 53, the bypass line 75 is opened. The distal end side connection port 74 and the proximal end side connection port 77 are individually opened to the outside. When the tissue collection device 54 is removed from the attachment 53, a plug 110 as shown in FIG. 13 is attached to the attachment 53, and the distal end side connection port 74, the proximal end side connection port 77, and the side surface of the bypass conduit 75 The 53D side can be closed to the outside. The plug body 110 includes a grasping portion 111 held by an operator, a distal end side protrusion 112 (first plug body) fitted into the first and second connection pipes 73 and 76 one by one, and a proximal end protrusion. 126 (second stopper). On the outer periphery of each of the protrusions 112 and 126, annular protrusions 112A and 126A that are engaged with the annular grooves 74A and 77A are projected. The distal projection 112 stops before the bypass conduit 75, but the proximal projection 126 enters the second connecting conduit 78 beyond the bypass conduit 75. The proximal end protrusion 126 has a hollow shape, and a hole 114 communicating with the bypass conduit 75 is formed in a part thereof. Therefore, in a state where the plug body 110 is mounted on the attachment 53, the first connection pipeline 73 and the second connection pipeline 76 communicate with each other via the bypass pipeline 75. Note that the distal-end projection 112 and the proximal-end projection 126 may be two separated plugs.

The operation of this embodiment will be described.
First, as shown in FIG. 12, the tissue collection device 54 is attached to the attachment 53. Further, the first and second connection portions 68 and 69 of the endoscope operation unit 60 are fitted into the first and second connection pipelines 70 and 78 of the attachment 53, respectively, so that the attachment 53 is connected to the endoscope 52. To fix. At this time, as shown in FIG. 4, the attachment 53 is mounted with the side surface 53 </ b> E (first surface) facing the endoscope operation unit 60. Accordingly, the tissue collection device 54 attached to the side surface 53C (second surface) side is disposed on the opposite side of the endoscope operation unit 60 with the attachment 53 interposed therebetween. In this state, the endoscope insertion portion 61 is inserted into the body, and a treatment tool (for example, excision forceps) is inserted from the treatment tool insertion port 71 of the attachment 53. The treatment tool enters the working channel 65 on the endoscope 52 side from the first connection conduit 70 of the attachment 53 and protrudes from the distal end portion of the endoscope insertion portion 61. When the tissue to be collected is excised with the treatment tool, the treatment tool is extracted from the endoscope 52 and the attachment 53. The treatment instrument insertion port 71 is closed and sealed with its own restoring force.

  When the excised tissue is aspirated, the aspirator 5 is operated. Suction line 66 (including the second connection line 78 and the second connection line 76 of the attachment 53), the tissue recovery device 54, the first connection line 73, and the work channel 65 (first A suction force acts on the tissue. As shown by arrows in FIG. 3, the tissue reaches the branching portion 72 from the working channel 65 together with the surrounding fluid, and is guided from the branching portion 72 to the first connection pipe 73 to enter the space 89 </ b> A of the tissue recovery device 54. Be drawn. The tissue is caught on the tissue capturing surface 96A of the filter unit 96 in the space 89A. The fluid passes through the mesh of the filter unit 96, is guided from the groove 88 to the space 89 </ b> B, and is discharged from the suction device 5 through the suction line 66 from the attachment 53. When the tissue is captured, the aspirator 5 is stopped. The tissue recovery filter 81 is removed from the tissue recovery case 80 to recover the tissue.

  Since the tissue collection device 54 is inclined in a direction in which the opening 83 side is separated from the attachment 53 in the left-right direction, the tissue collection filter 81 can be easily removed without interfering with the endoscope operation unit 60. At this time, the tissue recovery filter 81 can be detached with one hand because the engagement with the tissue recovery case 80 is released simply by grasping the pair of fixing portions 97 so as to be close to each other. In addition, since the opening 83 side is inclined upward in the vertical direction, even if the liquid remains in the case main body 82, the liquid does not flow out. When a large amount of liquid remains, the notch 101 is present in the plate 100 of the tissue recovery filter 81, so that the liquid is not scraped out of the case body 82. When the tissue collection filter 81 is removed, the cover 86 is raised by the biasing force of the coil spring 90 until it comes into contact with the stepped portion 91 on the opening 83 side. As a result, the case main body 82 is sealed with the sealing material 87 of the lid 86.

  According to this embodiment, since the tissue recovery device 54 is configured to be connected to the endoscope 52 via the attachment 53 used for insertion of the treatment tool, a conduit for the tissue recovery device 54 is provided outside. Therefore, the operator can easily operate the endoscope 52. Since the tissue collection device 54 is fixed in the vicinity of the endoscope operation unit 60, the operator can easily handle the tissue collection device 54. Since the tissue collection device 54 is attached at a position where it does not interfere with the endoscope 52, the operability is good. Since the tissue collection device 54 is inclined so that the opening 83 is on the top, it is easy to remove and the liquid inside does not easily flow out. Since the tissue recovery filter 81 can be clicked on and removed from the tissue recovery case 80, an operation such as removal while holding the endoscope 52 is facilitated. This also facilitates the operation of continuously removing tissue by attaching and detaching the tissue recovery filter 81 a plurality of times. In a state where the tissue recovery filter 81 is removed, the lid 86 seals the inside of the case main body 82, so that airtightness in the passage can be maintained.

  In the attachment 53, the tissue collection device 54 is connected to a pipe line branched from the middle of the work channel 65 by the branch portion 72, so that the treatment tool can be easily inserted and removed. When the plug 110 (see FIG. 13) is attached with the tissue collection device 54 removed, the air tightness of the conduit can be maintained. Further, the working channel 65 and the suction pipe 66 can be communicated with each other through the bypass pipe 75. Since the bypass pipe line 75 is opened to the side surface 53D, cleaning with a cleaning brush inserted is easy. Since the attachment 53 is made of an elastic member, it can be easily attached to and detached from the endoscope 2 and an airtight structure can be easily constructed. Further, since the attachment 53 is made of a material that is relatively soft compared to the endoscope 2, the endoscope 2 is not easily worn by repeated attachment and detachment. For this reason, the cost as the endoscope system 1 as a whole can be reduced.

A modification of this embodiment will be described below.
The attachment 120 shown in FIG. 14 has a bypass conduit 121 that does not open to the side surface 53D. The plug body 125 applied to the attachment 120 includes a grip portion 111, a distal end side projection 112 (first plug body), and a proximal end side projection 126 (second plug body). The length of the base end side protrusion 126 is shorter than the length from the base end side connection port 77 to the joining position of the bypass conduit 121. The proximal end protrusion 126 is locked to the second connection conduit 76 by the annular protrusion 126A. The work channel 65 is communicated with the suction line 66 via the first connection line 73, the bypass line 121, and the second connection line 76.

  The attachment 130 shown in FIGS. 15 and 16 does not have a bypass pipeline. When the tissue collection device 54 is removed, the connecting tube 135 (connecting member) is attached. Both ends of the connecting pipe 135 are a distal end side connecting portion 136 and a proximal end side connecting portion 137. These connection portions 136 and 137 are fitted into the first and second connection pipes 73 and 76. Such a connecting pipe 135 is manufactured with resin, an elastic member, or the like. When the connecting pipe 135 is mounted, the distal end side connection port 74 and the proximal end side connection port 77 are sealed from the outside, and work is performed via the first connection pipe 73, the connection pipe 135, and the second connection pipe 76. The channel for use 65 and the suction line 66 communicate with each other.

  The tissue recovery filter 140 shown in FIG. 17 has a slit 142 in a U-shape in the filter part 141. The slit 142 is formed in the tissue capturing surface 96 </ b> A perpendicular to the mesh, and a region surrounded by the slit 142 is a movable portion 143. As shown in FIG. 18, when the movable part 143 is pushed with a finger while the tissue is captured, the captured tissue can be easily detached. Another form of the movable part 143 is shown in FIG. The tissue recovery filter 150 has a frame 152 extending from the main body 151. A groove 153 is formed along the inner periphery of the frame body 152, and a movable portion 154 is inserted therein. The movable portion 154 has a mesh structure and allows a fluid to pass therethrough, but a tissue capturing surface 154A for capturing tissue is formed on each of the front surface and the back surface. Since the groove 153 has play with respect to the outer dimension of the movable portion 154, the tissue can be detached by moving the movable portion 154 by hand.

  Further, a tip opening portion of the working channel 65 as shown in FIGS. 20 to 23 may be used. The distal end opening 160 of the working channel 65 shown in FIGS. 20 and 21 is formed from a tapered surface 161 having an inclination angle α with respect to the outer diameter of the working channel 65, and the distal end side is enlarged in diameter. . Here, the angle α is an angle greater than 0 ° and equal to or less than 5 °. Below 0 °, it becomes difficult for the tissue to enter the working channel 65 in the case of a relatively large tissue. If it exceeds 5 °, the tapered surface 161 is likely to be clogged with tissue. 22 and 23 has a tapered surface 163 having an inclination angle β. The tapered surface 163 is eccentric with respect to the axis of the working channel 65. The inclination angle β is greater than 0 ° and 5 ° or less. The reason and the action of the tip opening 162 are the same as those shown in FIG.

(Third embodiment)
A third embodiment will be described with reference to FIGS. The third embodiment shows a modification of the attachment and the tissue collection device. The same components as those in the above embodiments are denoted by the same reference numerals. In addition, overlapping explanation is omitted.
As shown in FIG. 24, the attachment 170 includes a main body 171 and a valve body 172 that is rotatably inserted into the main body 171. The main body portion 171 includes a first connection pipeline 70, and the first connection pipeline 70 is provided with a treatment instrument insertion port 71 that opens to the upper surface 171 </ b> A, and from the branch portion 72 to the first connection pipeline. 73 is branched. The first connection conduit 73 communicates with the insertion hole 173 into which the valve body 172 is inserted. The insertion hole 173 has a large diameter part 175 and a small diameter part 176. In the main body 171, a first connecting pipe 73 is opened in the large diameter portion 175 of the insertion hole 173. Further, a hole 177 is formed at a position rotated about 90 ° in the circumferential direction from the connection position of the first connection pipe line 73. The hole 177 opens to the upper surface 171A and extends toward the lower surface 171B beyond the insertion hole 173, but does not penetrate the lower surface 171B. The upper side from the insertion hole 173 of the hole 177 becomes the tip side opening 178, and the lower side from the insertion hole 173 of the hole 177 becomes the insertion hole 179. A through hole 180 is formed in the small diameter portion 176 of the insertion hole 173. In the through hole 180, the upper surface 171 </ b> A side of the insertion hole 173 is a base end side connection port 181. The lower surface 171 </ b> B side of the insertion hole 173 becomes the second connection pipe line 182.

  The valve body 172 is inserted in the insertion hole 173 so as to be rotatable around the axis while maintaining airtightness. The valve body 172 has a small-diameter distal end 185 and a large-diameter proximal end 186. The proximal end portion 186 is provided with a knob 187 for allowing the operator to rotate the valve body 172. A bypass conduit 188 is formed in the valve body 172. The bypass pipe line 188 is sealed at the base end 186 side.

  The base end portion 186 of the valve body 172 has two through holes 191 and 192 formed coaxially, and a through hole 193 formed at a position orthogonal to the through holes 191 and 192. When the valve body 172 is inserted into the main body 171 at the rotational position (first rotational position) shown in FIG. 24, the through-hole 191 is connected to the distal end side opening 178 and the bypass conduit as shown in FIG. 188 is communicated, and the through hole 192 communicates the insertion hole 179 and the bypass conduit 188. The through hole 193 allows the first connection pipe line 73 and the bypass pipe line 188 to communicate with each other. 26, the through hole 191 is connected to the first connecting pipe 73 and the through hole 193 is an insertion hole at a position rotated 90 ° clockwise as indicated by an arrow from the rotational position shown in FIG. 179. The through hole 192 is sealed.

  Similarly, the tip 185 of the valve body 172 shown in FIG. 24 has two through holes 195 and 196 formed coaxially, and a through hole 197 formed at a position orthogonal to the through holes 195 and 196. Have When the valve body 172 is inserted into the main body 171 at the first rotational position shown in FIG. 24, the through-hole 195 connects the proximal end side connection port 181 and the bypass conduit 188 as shown in FIG. The through hole 196 allows the second connecting pipe line 182 and the bypass pipe line 188 to communicate with each other. The through hole 197 is sealed by the main body portion 171. 26, the through hole 195 and the through hole 196 are blocked by the main body portion 171 and the through hole 197 is connected to the second connection at the second rotation position rotated 90 ° clockwise as indicated by the arrow from the rotation position shown in FIG. It leads to the pipe line 182.

  FIG. 28 shows a tissue recovery apparatus 200 used with the attachment 170. The tissue recovery apparatus 200 includes a tissue recovery case 201 and a tissue recovery filter 81. The tissue recovery case 201 has the same configuration as that of the second embodiment except that the distal end side pipe line 202 and the proximal end side pipe line 203 are arranged at predetermined intervals in the axial direction from the case body 82. is there. The distal end side pipe line 202 and the proximal end side pipe line 203 extend in parallel after being bent. On the side of the distal end side pipe line 202, a connection pipe line 204 that connects the inside and the outside at a predetermined position is formed.

  When the tissue collection device 200 is not attached, the valve body 172 is set to the second rotational position. The first connecting pipe 70 is connected to the second connecting pipe 182 through the bypass pipe 188 of the valve body 172. Since the other through holes 192, 193, 195, and 196 of the valve body 172 are blocked by the main body portion 171, the working channel 65 and the suction pipe 66 are communicated with each other while keeping airtightness from the outside.

  As shown in FIG. 29, when attaching the tissue collection device 200 to the attachment 170, the valve body 172 is set to the first rotation position. The distal end side pipe line 202 is inserted into the distal end side opening 178, penetrates the valve body 172, and is fitted into the insertion hole 179. At this time, the connection pipeline 204 of the distal end side pipeline 202 and the first connection pipeline 73 communicate with each other. The proximal end side pipe line 203 is inserted into the proximal end side connection port 181, passes through the valve body 172, and is fitted into the second connecting pipe line 182. Since the airtight structure is formed by the proximal end side connection port 181 and the second connection pipe line 182, the bypass pipe line 188 is blocked, and the first connection pipe line 70 and the first connection pipe line 182 are blocked by the pipe line passing through the tissue recovery apparatus 200. The two connecting pipe lines 182 communicate with each other.

  When the tissue is recovered using the attachment 170 and the tissue recovery apparatus 200, the attachment 170 is attached to the endoscope 52. The working channel 65 (including the first connection line 70) and the suction line 66 (including the second connection line 182) are communicated with each other via the tissue recovery apparatus 200. Subsequent operations are performed in the same manner as in the second embodiment. The tissue is captured by the filter unit 96 (see FIG. 8) from the working channel 65 through the branching portion 72, the first connection pipe 73, and the distal end side pipe 202. The fluid is discharged from the proximal end side pipe line 203 and sucked into the suction pipe line 66.

According to this embodiment, since the tissue recovery apparatus 200 is connected to the endoscope 52 via the attachment 170 used for inserting the treatment instrument, the conduit for the tissue recovery apparatus 200 is routed to the outside. Therefore, the operator can easily operate the endoscope 52. Since the tissue collection device 200 is fixed in the vicinity of the endoscope operation unit 60, the operator can easily handle the tissue collection device 200.
When the tissue collection device 200 is removed, the pipe line can be sealed from the outside by rotating the valve body 172 without mounting a separate plug body. Further, the working channel 65 and the suction line 66 can be communicated with each other via the bypass line 188. Therefore, the operation when the tissue recovery apparatus 200 is removed can be simplified.

The present invention can be widely applied without being limited to the above-described embodiments.
For example, the tissue recovery device may be configured to be attached to the endoscope 2 or the attachments 53 and 170, and is not limited to the configuration of the tissue recovery devices 3, 54, and 200 of each embodiment.

Examples of other attachments and tissue recovery devices that can solve the same problems as those of the present invention are shown in FIGS.
In the attachment 210 shown in FIGS. 30 and 31, a valve body 212 is rotatably inserted into a main body portion 211. The first connection conduit 214 and the second connection conduit 215 pass through the main body 211 in parallel so as to pass through the insertion hole 213 into which the valve body 212 is inserted. A forceps plug lid 217 is detachably provided at the distal end opening 216 of the first connection conduit 214 that opens to the upper surface 211A of the main body 211. In addition, the opening of the second connecting conduit 215 on the upper surface 211 </ b> A serves as a proximal end side connection port 218. The valve body 212 is rotatably inserted into the insertion hole 213 while keeping airtightness. The valve body 212 has a bypass conduit 220 formed therein. On the base end side of the valve body 212, four through holes 221 A, 221 B, 221 C, and 221 D are formed at equal intervals in the circumferential direction of the valve body 212 at a position corresponding to the first connection pipe line 214. Further, three through holes 222A, 222B, and 222C are formed on the distal end side of the valve body 212 at a position corresponding to the second connecting conduit 215. The through hole 222A and the through hole 222C are arranged on the same line, and the through hole 222B is formed at a position shifted by 90 ° from the two through holes 222A and 222C.

  As shown in FIG. 32, when the valve body 212 is in the first rotation position, the first connection pipe line 214 and the bypass pipe line 220 are connected by the through hole 221B. In the second connection conduit 215, only the suction conduit 66 is connected to the bypass conduit 220 through the through hole 222B. As a result, the working channel 65 and the suction conduit 66 are connected via the bypass conduit 220. The remaining through holes 222A and 222C are sealed by the main body 211. In this case, when the forceps plug lid 217 is attached, the distal end opening 216 and the through hole 221 are isolated from the outside. When the forceps plug lid 217 is removed, a treatment tool such as forceps can be inserted. As shown in FIG. 31, in the second rotational position, the first and second connection pipelines 214 and 215 communicate with each other, and the connection pipelines 214 and 215 communicate with each other through the bypass pipeline 220. To do. Here, as shown in FIG. 33, when the tissue recovery device 240 including the connection conduit 230 is attached, the working channel 65 and the suction conduit 66 are connected via the internal conduit of the tissue recovery device 240, and the bypass tube The path 220 is closed. Here, the tissue recovery device 240 includes a tissue recovery case 241 and a tissue recovery filter 243 inserted from the opening 242 of the tissue recovery case 241, and the bottom 241 A of the tissue recovery case 241 includes A proximal side conduit 244 is provided. A connecting conduit 230 is connected to the side of the tissue collection case 241. The connection conduit 230 is a conduit communicating with the inside of the tissue recovery case 241 and is bent in an L shape. A valve body 231 is rotatably inserted in a corner portion of the connection pipe line 230. The valve body 231 is rotatably mounted on a rubber support portion 232 that covers a corner portion of the connection pipe line 230, and is kept airtight with respect to the outside. The valve body 231 is hollow inside and has one through hole 233 formed therein. When the through hole 233 is aligned with the insertion line 230 </ b> A of the connection line 230, the connection line 230 communicates and the tissue can be collected. When the valve body 231 is rotated and the position of the through hole 233 is shifted, the connecting pipe line 230 is sealed.

  When the aspirator 5 (see FIG. 3) is operated with the tissue collection device 240 mounted, the tissue is guided from the working channel 65 through the connection line 230 into the tissue collection device 240, and is similar to FIG. It is captured by the filter unit having the configuration. The fluid is further discharged from the proximal end side pipe 244 through the suction pipe 66.

It is a figure showing the schematic structure of the endoscope system concerning an embodiment of the invention. It is a partially expanded sectional view of FIG. 1, Comprising: It is a figure which shows schematic structure of a structure | tissue collection apparatus. It is a figure which shows schematic structure of an endoscope system. It is a figure which shows the state which mounted | wore the endoscope through the attachment with the tissue collection | recovery apparatus. It is a perspective view of an attachment. It is A arrow directional view of FIG. It is sectional drawing which shows the structure of a tissue collection | recovery apparatus. It is sectional drawing of a structure | tissue collection apparatus. It is sectional drawing which shows the case for structure | tissue collection when the filter for structure | tissue collection is removed. It is a figure which shows the structure of the filter for structure | tissue collection. It is C arrow line view of FIG. 10, Comprising: It is a figure which shows the shape of a plate. It is sectional drawing which shows the state which mounted | wore the attachment with the tissue collection | recovery apparatus. It is a figure which shows the attachment state of the plug body to an attachment. It is a figure which shows the plug with respect to the attachment which the bypass pipe line does not open to the side surface. It is a perspective view of an attachment which does not have a bypass line. It is a figure which shows the structure of the plug with respect to the attachment shown in FIG. It is a figure which shows the filter for structure | tissue collection | recovery which has a movable part. It is explanatory drawing of operation which takes out a structure | tissue by pushing a movable part with a finger | toe. It is a partially broken figure which shows the structure of the filter for structure | tissue collection | recovery from which the movable part was comprised from the different body. It is sectional drawing of the front-end | tip part of an endoscope insertion part, Comprising: It is a figure which shows the shape of the front-end | tip part of a working channel. It is a D arrow line view of FIG. It is sectional drawing of the front-end | tip part of an endoscope insertion part, Comprising: It is a figure which shows the shape of the front-end | tip part of a working channel. It is E arrow line view of FIG. It is a top view which shows the structure of the attachment which has a valve body. It is a perspective view of the attachment shown in FIG. It is sectional drawing along the FF line of FIG. It is sectional drawing along the GG line of FIG. It is a perspective view which shows an attachment and a tissue collection | recovery apparatus. It is a perspective view which shows the state which mounted | wore the tissue collection | recovery apparatus with the attachment. It is a perspective view which shows an attachment and a tissue collection | recovery apparatus. It is sectional drawing which shows an attachment and a tissue collection | recovery apparatus. It is a figure which shows the state which rotated the valve body to the 2nd position. It is a figure which shows the state which mounted | wore the tissue collection | recovery apparatus.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1,51 Endoscope system 2,52 Endoscope 3,54,200 Tissue collection | recovery apparatus 10,60 Endoscope operation part 11,61 Endoscope insertion part 20,66 Suction conduit 22,72 Branch part 23, 65 Working channel 53, 120, 130, 170 Attachment 53C Side surface (second surface)
53E Side (first side)
70 First connecting pipe (working channel)
73 First connection pipe 74 Tip side connection port 75, 121, 188 Bypass pipe 76 Second connection pipe 77 Base end side connection port 78 Second connection pipe (suction pipe)
80 Tissue recovery case 81,140 Tissue recovery filter 96A Tissue capture surface 112 Tip protrusion (first plug)
126 Proximal projection (second plug)
135 Connecting pipe (connecting member)
172 Disc

Claims (12)

An endoscope having an endoscope operation unit operated by an operator and an endoscope insertion unit extending from the endoscope operation unit and inserted into the body;
A pipe line in which a distal end opening is formed at a distal end portion of the endoscope insertion portion, and a proximal end portion is connected to an aspirator through the endoscope;
With
The pipeline is
A working channel in which an intermediate opening is formed in the endoscope operation section and a treatment tool can be inserted from the intermediate opening toward the distal end opening;
A suction conduit having one end communicating with the working channel in the endoscope operation section and the other end connected to the suction device as the base end;
Have
The endoscope operation section includes a downstream side of the working channel in the suction direction by the suction device from the proximal end portion of the conduit, and a direction from the distal end opening toward the suction device through the conduit. A tissue collection device capable of capturing the tissue to be aspirated is provided ;
A branch portion where the working channel and the suction pipe are branched is connected to the endoscope operation portion,
The endoscope system according to claim 1, wherein the tissue collection device is interposed between the branch portion and the suction conduit . An attachment in which a part of the working channel including the branch portion and a distal end portion of the suction conduit connected to the tissue recovery apparatus are formed to be detachable integrally with the endoscope operation portion. The endoscope system according to claim 1 . The endoscope system according to claim 2 , wherein the tissue collection device is detachable with respect to the attachment. The endoscope system according to claim 2 , wherein the attachment is manufactured from an elastic member. The attachment has a bypass line that bypasses the tissue recovery apparatus and connects the connection line and the suction line, and the bypass line is blocked when the tissue recovery apparatus is attached, The endoscope system according to claim 3 , wherein the endoscope system is opened when the tissue collection device is removed. The endoscope system according to claim 1, wherein the tissue collection device includes a tissue collection case and a tissue collection filter that is detachable from the tissue collection case. The attachment includes a main body part that is attached to and detached from the endoscope, and a valve body that is rotatably inserted into the main body part. The valve body includes a distal end part of the suction conduit, and the working part. A first rotation position for communicating the base end of the channel via a bypass line, the bypass line is shut off, and the tip end of the suction line and the base end of the working channel are each The endoscope system according to claim 3 , wherein the endoscope system is rotatably inserted so as to be able to select a second rotational position to be opened to the outside separately. The tissue recovery filter is provided with two tissue capturing surfaces integrated on the front and back sides, and the tissue recovery surface is arranged so that the tissue capturing surface is substantially orthogonal to a fluid flow path for sucking tissue. The endoscope system according to claim 6 , wherein the tissue collection filter is configured to be mounted as described above. A distal-side connection port provided at a proximal end of the connection conduit of the attachment and connectable to the tissue recovery device; and a tissue recovery device provided in a conduit forming the distal end of the suction conduit in the attachment The endoscope system according to claim 3 , further comprising a connecting member that is attachable to a proximal-side connection port that can be connected to the fluid and that fluidly connects the working channel and the suction conduit. When removing the tissue recovery device from the attachment, the first plug body that can be attached to the connection port on the distal end side of the connection pipe line that is opened to the outside when the tissue recovery device is removed from the attachment, and when the tissue recovery device is removed from the attachment The endoscope system according to claim 5 , further comprising a second plug body that is attachable to a distal end side connection port of the connection pipe line that is open to the outside. The attachment has a first surface that faces the endoscope operation unit when the attachment is attached to the endoscope operation unit, and the tissue recovery device is disposed on a second surface opposite to the first surface. The endoscope system according to claim 2 , wherein the endoscope system is configured to be arranged. The endoscope system according to claim 1, wherein the tissue collection device is detachable from the suction conduit.

Images